Aim: The aim was to study the epidemiological, clinical and therapeutic aspects of pancreatic cancers in Ivory Coast. Materials and methods: A retrospective multi-center and multidisciplinary study aimed at describing sixteen years and four months from January 1, 2000 to April 30, 2016 in several hospitals in the city of Abidjan taking charge of pancreatic cancers (hepato-gas troenterology services of the universities hospitals of Cocody and Yopougon), internal medicine departments of University Hospital of Treichville and Abidjan Military Hospital, the department of oncology of the university hospital center of Treichville, private clinics (DANGA, PISAM and GMP), the COBA center in Treichville. The diagnosis of cancer was based on either histological criteria or a set of clinical and paraclinical arguments. Patients whose files did not include imaging were excluded from this study. The following parameters were collected: age, sex, reason for consultation, physical signs, personal and family antecedents, tumor characteristics, delay in diagnosis and the nature of the treatment administered. Results: We have observed 150 cases of pancreatic cancer. The mean age of patients was 59.09 years with extremes ranging from 24 years to 88 years. Our study population consisted of 98 men and 52 women (sex ratio 1.88). Risk factors were dominated by diabetes 20.7%. Epigastralgia is the main reason for consultation (48%). The tumor was localized at the cephalic level in 84.67%. In 13 cases the diagnosis was histological and was dominated by adenocarcinoma (100%). The majority of our patients was seen at an advanced stage of the disease: stage IV (74.56%). The average time to diagnosis was 2.76 months. Fourteen of our patients (9.33%) had benefited surgery. This was curative surgery in 35.71% (n = 5) and palliative in 64.29% (n = 9). Among those who benefited from this curative surgery, three died two months after surgery and two lost to follow-up. The majority (90.67%) of our patients had received symptomatic treatment. Conclusion: Pancreatic cancer is an appalling cancer with a very bad and late diagnosis because of its insidious symptomatology. Most of the time, tumors had already metastasized before diagnosis, so the treatment is often symptomatic.
References
[1]
Abdelmajid, M., Mongl, M. and Fethic, C. (2000) Traitement chirurgical palliatif du cancer de la tete du pancrea. A propos de 42 cas. La Tunisie Chirurgicale, 12, 66-73.
[2]
Prevost, F., Roos, S., Rousset, J.F., Fourtanier, G. and Escat, J. (2001) Traitement chirurgical des adenocarcinomes de la tête du pancreas et de la region peri-ampullaire. A propos de 213 cas. Annales De Chirurgie, 41, 12-17.
[3]
Stewart, B.W. and Kleihues, P. (2003) World Cancer Report 2003.
www.iarc.fr/en/publications/pdfs-online/wcr/2003/
[4]
Coulibaly, S., Keita, K., Sissoko, S.B., Diallo, M., Toure, M. and Sibide, S. (2015) Apport de l’echographie dans le diagnostic des tumeurs du pancreas au service de radiologie du chu du point G. Journal Africain Imagerie Médicale, 7, 163-169.
[5]
Mbengue, M., Kra, M.M., Diouf, M.L., Ka, E.F., Pouye, A., Dangou, J.M., et al. (2000) Apport de l’echographie dans l’epidemiologie, le diagnostic et pronostic du cancer du pancreas au sénégal. JEMU, 24, 225-229.
[6]
Moumen, M., El-alaoui, M.E, Mokhtari, M. and EL Fares, F. (1991) Notre experience du traitement du cancer de la tête du pancreas: A propos de 146 cas. Medicine du Maghreb, 30, 33-36.
[7]
Bouglouga, O., Lawson-Ananissoh, L.M., Bagny, A., Kaaga, L. and Redah, D. (2015) Pancreatic cancer: Epidemiological, clinical, and management aspects in the department of hepatogastroenterology at the Lome Campus teaching hospital (Togo). Médecine et Santé Tropicale, 25, 323-326.
[8]
El, G.S., Ben, N.S., Afrit, M., Labidi, S. and Boussen, H. (2015) Exocrine Pancreatic carcinoma in Tunisia: A retrospective study about 158 cases. La Tunisie Medicale, 93, 73-75.
[9]
Raissouni, S., Rais, G., Mrabti, H., Raissouni, F., Mouzount, H., Aitelhaj, M., et al. (2012) Pancreatic adenocarcinoma in young adults in a moroccan population. Journal of Gastrointestinal Cancer, 43, 607-611.
https://doi.org/10.1007/s12029-012-9407-0
[10]
Hana, T.A., Amani, A.E., Shihab, H.A., Rogini, G. and Glory, B.R. (2013) Pancreatic Cancer: Incidence, Clinical Profile and Frequency of Associated Factors in Kuwait. Alexandria Journal of Medicine, 49, 75-80.
https://doi.org/10.1016/j.ajme.2012.06.004
[11]
Qiu, M., Jin, Y., Wei, X., Zhou, Y., Wang, Z., Wang, D., et al. (2016) Pathologic Diagnosis of Pancreatic Adenocarcinoma in the United States: Its Status and Prognostic Value. Journal of Cancer, 7, 694-701. https://doi.org/10.7150/jca.14185
[12]
Ntagirabiri, R., Niyonkuru, S., Karayuba, R., Ndayisaba, G. and Marerwa, G. (2012) Cancer du pancreas au Burundi, experience du CHU de kamenge. Journal African d’Hépato-Gastroentérologie, 6, 312-314. https://doi.org/10.1007/s12157-012-0422-3
[13]
Almadi, M.A., Alharbi, O., Ozzam, N., Altayeb, M., Javed, M., Alsaif, F., et al. (2013) Clinical Predictors of Resectability of Pancreatic Adenocarcinoma. Saudi Journal of Gastroenterology, 19, 278-285. https://doi.org/10.4103/1319-3767.121036
[14]
Sellam, F., Harir, N., Khaled, M.B., Mrabent, N.M., Salah, R. and Diaf, M. (2015) Epidemiology and Risk Factors for Exocrine Pancreatic Cancer in a Northern African Population. Journal of Gastrointestinal Cancer, 46, 126-130.
https://doi.org/10.1007/s12029-015-9693-4
[15]
Elena, J.W., Steplowski, E., Yu, K., Hartage, P., Tobias, G.S., Brotzman, M.J., et al. (2013) Diabetes and Risk of Pancreactic Cancer: A Pooled Analysis from the Pancreatic Cancer Cohort Consortium. Cancer Causes Control, 24, 13-25.
https://doi.org/10.1007/s10552-012-0078-8
[16]
Fuchs, C.S., Colditz, G.A. and Stampfer, M.J. (1996) A Prospective Study of Cigarette Smoking and the Risk of Pancreatic Cancer. Archives of Internal Medicine, 156, 2255-2260. https://doi.org/10.1001/archinte.1996.00440180119015
[17]
Lowenfels, A.B. and Maisonneuve, P. (2004) Epidemiology and Prevention of Pancreatic Cancer. Japanese Journal of Clinical Oncology, 34, 238-244.
https://doi.org/10.1093/jjco/hyh045
[18]
Randall, E.B., Ulia, B.G., Ugene, Z., Honda, B., Ongyan, D., Iane, S., et al. (2009) Pancreatic Cancer Patients Who Smoke and Drink Are Diagnosed at Younger Ages. Gastroenterology and Hepatology, 7, 1007-1012.
[19]
Mahid, S.S., Minor, K.S. and Stevens, P.L. (2007) The Role of Smoking in Crohn’s Disease as Defined by Clinical Variables. Digestive Diseases and Sciences, 52, 2897-2903. https://doi.org/10.1007/s10620-006-9624-0
[20]
Maisonneuve, P. and Mullhaupt, B. (2005) Cigarette Smoking Accelerates Progression of Alcoholic Chronic Pancreatis. Gut, 54, 510-514.
https://doi.org/10.1136/gut.2004.039263
[21]
Lakatos, G., Balazs, A., Kui, B., Godi, S., Szucs, A., Szentesi, A., et al. (2016) Pancreatic Cancer: Multicenter Prospective Data Collection and Analysis by the Hungarian Pancreatic Study Group. Journal of Gastrointestinal and Liver Diseases, 25, 219-225.
[22]
Qiubo, Z., Linjuan, Z., Yinting, C., Guoda, L., Chenchen, Q., Shaojie, C., et al. (2016) Pancreatic Cancer Epidemiology, Detection and Management. Gastroenterology Research and Practice, 2016, Article ID: 8962321.
[23]
Picozzi, V.J., Kozarek, R.A. and Traverso, L.W. (2003) Interferon-Based Adjuvant Chemoradiation Therapy after Pancreaticoduodenectomy for Pancreatic Adenocarcinoma. The American Journal of Surgery, 185, 476-480.
